G&P Waiver

Release of Liability and Medical Release
BY CHECKING THIS BOX I ACKNOWLEDGE THAT I AM OVER 18 YEARS OF AGE*

I AGREE
Location *
Participants Name (First and Last)*
Birth Date*

MonthDayYear
Date
Email*
example@example.com
Home/Cell Phone
Parent/Guardian Name
Contact #
Emergency Contact Name*
Emergency Contact Phone Number*
- I give myself/son/daughter permission to participate in Process Skateboard Ministry/G&P Indoor Skate Park activities. I understand that there is serious risk and even death involved when traveling and participating in skateboard activities and programs. Understanding Process Skateboard Ministry/G&P Indoor Skate Park will take every reasonable effort to create a safe environment and to look after the well being of myself/my child, I release Process Skateboard Ministry/G&P Indoor Skate Park from all liability while myself/my child is in their care.

-I give Process Skateboard Ministry/G&P Indoor Skate Park permission to seek medical attention in the event that medical attention is needed, per their discretion.

-I willingly acknowledge that I am in/my child is in sufficient physical condition to participate in Process Skateboard Ministry/ G&P Indoor Skate Park activities.

-I agree to follow ALL posted rules while participating in Process Skateboard Ministry/ G&P Indoor Skate Park activities.

-I give Process Skateboard Ministry/G&P Indoor Skate Park the right to use any video or photographs taken while participating in their activities for media or promotional material.
Current Illnesses
Allergies
Current Medication
Medical Insurance Company
Policy Number
Participant Name Signed*

Clear
Date*

MonthDayYear
Date
Parent/Guardian Name Printed (If under 18)
Parent/Guardian Name Signed

Clear
Date

MonthDayYear
Date
Should be Empty:

Release of Liability and Medical Release